Individual
DERRICK HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4794 PELICAN BAY DR APT 202, MEMPHIS, TN 38125-5309
(662) 641-0308
Mailing address
4794 PELICAN BAY DR APT 202, MEMPHIS, TN 38125-5309
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/14/2018
Last updated
06/14/2018
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